Best's case scenarios too scary to not induce change

By now, the people who haven't seen Jahvid Best's head-plant in the Oregon State-California football game Saturday have been actively seeking to avoid it, and for good reason. Namely, it looks like a broken neck, a severed spinal cord, the end of a career, perhaps even worse.

But it only looks like those things. What it ended up being was a severe concussion, an overnight stay in the hospital and at least a full week away from football -- a microscopic price to pay, all things considered.

Cal's Jahvid Best couldn't find a safe, soft landing in the end zone Saturday night. (AP)

But the question that remains is an old but still viable one. When will sports teams, pro, college or even high school, be separated from the doctors who treat the players?

Before we go any further here, we are not using the Best case as proof that the Cal athletic medical department or the coaching staff deliberately allowed Best, who had incurred a concussion the week before, to run an unreasonable risk. We don't know, and we don't get unanimity of thought from doctors on the subject because, as one said, "Without access to his medical records, we're all guessing about everything."

But with what we know about the human head and its relationship to football (they are not friendly), it may be time to finally build that wall between teams and the medical advice their players receive, especially when it comes to brain work.

As in this: If a player is injured during a game, a physician or medical team is on hand to evaluate and treat. If the head is involved, the player cannot play any further until he has been sent to a hospital and evaluated by specialists who have no relationship to the team or the university, who will then solely determine when a player may return to duty.

Not the coach. Not the team doctor. Nobody from or connected to the university. Not even the player.

This is not a new idea; it has been proposed by ethicists, former players and other ne'er-do-wells for decades now. It has always been rejected on grounds of paternalism and control, and then, like most other health and safety issues in football suggested from outside, it is rejected until the evidence becomes overwhelming, or someone loses a lawsuit from a distraught family.

So like all circular issues whose time never seems to come until the evidence is beyond overwhelming, it is time again to bring the debate back, only this time with the new pile of medical studies, pictures of CAT scans and the clip of Best's landing as the lead-in to any discussion.

Again, this isn't about wrongdoing in the Best case, because we don't know to what extent there might have been any. Indeed, the incidents of proper medical treatment are unnoticed because there are so many more of them. The exception, after all, is typically louder than the rule.

No, this is about the conflict of interest itself, and the advancements in brain injury technology and information. These are human heads we're talking about here, and the people providing the diagnostic care to athletes should not be beholden in any way to the industry. The day of the company doctor has not yet passed; it is still a valuable and needed service for most incidents. But not for head injuries.

This regulation would doubtless lead to some teams trying to deny that players have suffered head injuries when they have so that they maintain control of care and a return date. The antiquated hockey tradition, "upper/lower body injury," and the NFL's weekly injury report fudging are proof that teams will manipulate even health and safety issues to their advantage, whether it's to hide an injury from another team or from the league and public itself.

That will continue until the notion "If you ain't cheatin', you ain't competin'" falls out of fashion, right around the time of falling temperatures in hell. But head shots should not be allowed to fall under that category, and the good intentions of the majority alone cannot be the consideration. There can't be close calls when it comes to brain trauma. You err on the side of time off, and the only way to guarantee that is for the physician making the call to have no connection to the team, or school.

And because football shouldn't feel singled out, this is a policy that should extend to all sports, not as an option as in "Well, they can go get a second opinion" to "They are required to get a first opinion that isn't tied to the company. Then they can get a second opinion if they want." The act of being cleared to play must now come from outside the industry, period, so that the Best incident and like events don't put teams and institutions at risk for the kind of accusations being raised by amateurs now, and don't put players at risk of playing before it is prudent to do so.

We are learning more and more about head injuries all the time, and one of the most obvious things is that they become repetitive injuries pretty quickly. The Best case is a freak because it was so out of the norm, but two concussions in a week are still two concussions in a week. That can't happen anymore, even with the best intentions and best in-house medical advice. In short, you don't have to be guilty to be wrong.

Ray Ratto is a columnist for the San Francisco Chronicle.